Újszeged Medical Center

We are increasingly focusing on the recognition and treatment of diabetes complications, as these significantly impact life expectancy. One reason for this is that unfortunately, even today, diabetes is often only brought to attention when complications occur, even though metabolic disturbances may have been present for decades. Another reason is that, thanks to advanced medical and insulin treatments (which aim to reduce blood sugar), diabetes is now well-managed, and we care for many patients who have been treated for decades and are at risk of developing late-stage complications.

According to current scientific understanding, maintaining a near-normal blood sugar level (normoglycemic state) prevents or at least delays microangiopathic (small blood vessel-related) complications and inhibits their progression. This means that even worsening complications of diabetes discovered at a late stage can be slowed down through proper metabolic control and targeted treatment of complications. Preventing macroangiopathic (large blood vessel-related) complications is only possible through the complex management of underlying causes.

The underlying cause of arterial narrowing is the hardening and narrowing of the artery walls. These blood vessels network throughout the entire body, and their damage can cause not only blood supply disruptions in the limbs but also severe problems when affecting the heart (angina pectoris) or brain. Factors that increase the risk of these conditions include lipid metabolism disorders and uric acid metabolism disturbances, which can be screened for through laboratory tests at our center.

Due to arteriosclerosis, the arteries become stiff, their inner diameter shrinks, and the volume of blood circulating through them decreases, leading to oxygen deficiency. The situation is worsened by fat deposits on the vessel walls, causing thickening that slows down blood flow, increasing the likelihood of clot formation. This tendency is further exacerbated when damage occurs on the thickened surfaces. These clots, as they travel through the bloodstream, can lodge in blood vessels anywhere in the body, causing partial tissue death in the affected organ. The dead tissue is replaced by scar tissue, which cannot participate in the organ's function. Clots in the neck or brain vessels often cause brain tissue death. In the brain, these dead areas may be small and located in less critical areas, which causes fewer symptoms. However, the larger the affected area, especially if it has a crucial function, the more pronounced the symptoms.

If the circulatory disturbance is transient (TIA), it typically causes dizziness, gait problems, numbness in the face, arms, or legs, clumsiness, speech difficulties, and cognitive disturbances that last for a short time and are not permanent. Rarely, the symptoms resolve without treatment, but timely hospital care plays an essential role in eliminating the cause of the circulatory disturbance, and restoring circulation within a few hours can lead to complete recovery. If circulation is not restored in time, the symptoms become permanent. Unfortunately, in many cases, the obstruction of important blood vessels causes brain strokes (CVI), or severe brain hemorrhages develop due to extremely high blood pressure, which damages significant areas of the brain and is generally irreversible. In such cases, the patient lives with a variety of neurological symptoms, the most feared being complete paralysis of one side of the body, speech and cognitive disorders, and urinary or bowel control problems. These various neurological symptoms can be improved with prolonged speech therapy and comprehensive neurological rehabilitation, but the success of this treatment is less likely the older the patient is or if they are not sufficiently cooperative. This is undeniably a huge challenge for both the patient and their family. Disturbances in brain circulation lead to high mortality, similar to coronary artery obstructions.

For these reasons, preventing cerebral arteriosclerosis is of utmost importance, which involves early screening and regular monitoring of blood lipids, sugar, uric acid metabolism, blood pressure, and the condition of the neck arteries. Timely neurological care, at least annual examinations for diabetics, can be beneficial in preventing brain circulation disorders.

In our Diabetes Center, we place particular emphasis on nerve damage and its screening in preventing the narrowing of cerebral arteries. We are paying increasing attention to this because recent scientific results show that patients who develop even asymptomatic neuropathy are at heightened risk for other cardiovascular complications. These findings are supported by the internationally recognized scientific work of our clinical diabetologists, which has been published not only in scientific papers and congresses but also in books. With this advanced knowledge, patients with neuropathy identified through screening can receive earlier care in cardiology, neurology, and nephrology, helping them avoid fatal consequences.

Managing complications usually requires the collaboration of multiple medical specialties. At the Újszeged Diabetes Center, this interdisciplinary care is unique, as we have outstanding specialists both in scientific research and clinical practice. With prior arrangement, the annual recommended complex complication screenings can be completed in just a few hours.

COMPLEX COMPLICATION SCREENING PACKAGE

• Laboratory tests – Risk screening (Blood lipids, Uric acid, HbA1c, Body fat, BMI, Blood pressure)
• Urine test – Protein excretion screening
• Neurometer – Nerve damage screening
• EKG – Coronary artery screening
• Doppler test – Peripheral artery narrowing examination